Why California and Oregon Broke With the CDC

Two blue states acknowledge that health precautions need to be balanced with other priorities.  

a mask lying in the street
Carlos Barria / Reuters

February 4, 2024, 6 AM ET

Recently, California surprised the public-health world by easing the state’s recommendations for asymptomatic people who test positive for COVID. The state previously urged them to isolate for five days to avoid infecting others. In a January memo, though, California Public Health Officer Tomás Aragón declared that “there is no infectious period for the purpose of isolation or exclusion.”

This policy change in the nation’s most populous state—which followed a similar move by Oregon last year—represents a remarkable break from the CDC, the federal agency whose recommendations have guided public-health policies since the coronavirus first arrived in the United States. Four years after the pandemic began, three years after vaccines gave Americans the option of protecting themselves, and a year after the Biden administration let the official public-health emergency lapse, the CDC still calls for five days of isolation even in asymptomatic COVID cases.

The question now is whether the other 48 states and the CDC itself will follow California and Oregon. Health and Human Services Secretary Xavier Becerra, whose department oversees the CDC, defended the disease-control agency’s current guidelines last week, while also noting that they are not mandatory. Emergency measures are more easily imposed than rescinded. Public-health agencies are good at telling people what to avoid but not at giving them permission to return to normal lives.

California and Oregon, two reliably blue states, are in a good position to lead; they were among the more cautious states at the height of the pandemic, and they are right to acknowledge that coronavirus-safety rules need to be weighed against other priorities—such as the need to keep schools and workplaces functioning. Public health has to take account of how members of the general public typically interact with one another in the world, and officials in both California and Oregon have explicitly cited the need to ease social disruptions caused by isolation policies. As California’s new guidance points out, COVID rules have effects that are “disproportionate to recommendations for the prevention of other endemic respiratory viral infections” such as influenza or RSV.

Before the policy change, one Oregon public-health official told The New York Times, children who appeared well but tested positive for COVID were being deprived of “a solid week of school,” and some adults without sick leave were missing work despite feeling healthy. The consequences of testing positive have been far-reaching enough under CDC rules that people have a strong incentive not to get tested in the first place.

Strict isolation requirements made far more sense earlier in the pandemic. The overwhelming majority of Americans have acquired some protection against the virus, either through vaccination, previous infection, or both—and have the option of getting more, via new booster shots that most people have yet to receive.

The policy change in California and Oregon has prompted some reasonable objections: The disease has killed more than 1 million Americans and was the third-leading cause of death last year. The decision was worrisome to those who see rising infection numbers caused by the latest winter surge of a virus that keeps mutating and keeps showing up in wastewater. Still, Oregon officials say the state’s infection rates since easing its isolation guidelines are in sync with the rest of the country’s.

Other objections are harder to justify as a basis for keeping people away from work or school. Some commentators have speculated that the rollback of rules by two liberal states acting of their own volition will encourage partisan attacks on COVID precautions more generally. But public-health restrictions are likeliest to elicit compliance when they’re narrowly tailored to current conditions and when health officials acknowledge the necessity to balance disease control and other societal needs.

Perhaps the CDC will eventually come around to California’s point of view. Ending school disruptions should be among the government’s highest priorities. Education Secretary Miguel Cardona is worried about chronic post-pandemic absenteeism across the country and is eager to bring student attendance back to normal.

California and Oregon have hardly given up on all safety precautions. Both states tell people who are sick with COVID to stay home until they are fever-free and recovering from any other symptoms, and they encourage people who test positive to mask around others and avoid contact with vulnerable people. Employees of California hospitals and nursing homes and certain other settings are still subject to more stringent rules than the new state guidelines for the general public.

Instructing the public to relax but not totally relax requires a tricky balance, but that shouldn’t keep individual states from trying.

The Atlantic